Addison’s disease

Overview

Your suprarenal glands, also known as adrenal glands, are positioned atop each of your kidneys and form an integral part of your endocrine system.

Adrenal insufficiency, or Addison’s disease, is an uncommon condition that occurs when the body fails to produce adequate amounts of certain hormones. Individuals with this condition typically experience reduced levels of cortisol and aldosterone, which are hormones produced by the adrenal glands.

The hormone cortisol plays a crucial role in the body’s response to stress, including stress caused by illness, injury, or surgery. It aids in regulating blood pressure, supporting heart health, strengthening the immune system, and regulating blood glucose levels.

A hormone called aldosterone has an impact on the ratio of potassium and sodium in your blood. Your kidneys’ ability to excrete fluid in the form of urine (pee) is subsequently regulated, which has an impact on blood volume and blood pressure.

Addison’s disease can affect anyone and has the potential to be life-threatening. Treatment typically involves hormone replacement therapy to compensate for the hormones that the body is not producing adequately.

Symptoms

The symptoms of Addison’s disease typically develop slowly, frequently over months. People with the disease may initially ignore the symptoms because it can progress so slowly. Then, a stressor—like an injury or illness—makes the symptoms worse.

Some symptoms could be:

• Exhaustion
• Fainting
• Decreased appetite
• Losing weight
• Dark skin pigmentation on certain areas of the body
• Decreased blood pressure
• Desire to consume salty foods
• Hypoglycemia, commonly referred to as low blood sugar
• Gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain
• Pain of the joint and muscle
• Hair loss
• Sexual problem
• Irritability
• Depression

Addisonian crisis or acute adrenal failure

The signs of Addison’s disease might occasionally strike out of nowhere. Life-threatening shock can result from acute adrenal insufficiency. For the following, seek immediate medical attention:

• Confusion
• Extreme weakness
• Legs or lower back aches
• Decreased blood pressure
• Diminished consciousness or delirium
• Severe stomach pain, vomiting, and diarrhea that cause dehydration

If you have any of the following common Addison’s disease symptoms, consult a doctor:

• Dehydration, commonly referred to as extreme water loss from the body
• Dark pigmentations of the skin in certain areas of the body
• Exhaustion
• Unintentional weight loss
• Vomiting, nausea, or abdominal pain
• Aches in the joints or muscles
• Fainting
• Craving to consume salt

Causes

The adrenal glands are damaged in Addison’s disease. The glands produce hormones that have an impact on practically all of the body’s organs and tissues as a component of the endocrine system. Cortisol and, frequently, aldosterone levels are too low when these glands are damaged.

There are two parts to the adrenal glands. The medulla, which is located inside, produces hormones similar to adrenaline. Corticosteroids are a class of hormones produced by the cortex, the outer layer. Among corticosteroids are:

• Glucocorticoids. Cortisol is one of these hormones that has an impact on the body’s capacity to convert food into energy. They assist the body in coping with stress and contribute to the immune system’s inflammatory response.
• Mineralocorticoids. Aldosterone is one of these hormones that balances the body’s sodium and potassium levels to maintain a healthy blood pressure range.
• Androgens. Small amounts of these sex hormones are produced by the adrenal glands in every person. They influence the development of male sexuality. Additionally, they have an impact on everyone’s libido, musculature, and sense of wellbeing.

Primary adrenal insufficiency

The cortex, the outermost layer of the adrenal glands, might sustain damage from time to time. Primary adrenal insufficiency is a disorder when the body is unable to produce enough hormones. Typically, autoimmune diseases, in which the body attacks itself, cause this. Another autoimmune disease is more common in Addison’s disease patients than in the general population.

Adrenal gland failure can also result from cancer spreading to the adrenal glands, adrenal gland bleeding, tuberculosis, or adrenal gland infection.

Secondary adrenal insufficiency

The pituitary gland produces Adrenocorticotropic Hormone (ACTH), which stimulates the adrenal cortex to produce its hormones. However, conditions such as inflammation, benign pituitary tumors, and pituitary surgery can result in insufficient production of ACTH by the pituitary gland. This, in turn, can cause the adrenal glands to produce inadequate levels of androgens and glucocorticoids. This type of adrenal insufficiency is known as secondary adrenal insufficiency.

Most secondary adrenal insufficiency symptoms are interchangeable with basic adrenal insufficiency symptoms. The skin of those who have secondary adrenal insufficiency is not discolored, and they are less prone to experience severe dehydration or low blood pressure. They are more susceptible to low blood sugar.

Abrupt discontinuation of corticosteroid medications, such as prednisone, used to manage conditions like arthritis or asthma, can result in transient secondary adrenal insufficiency. It is crucial to taper down the medication gradually to avoid this potential complication.

Risk factors

All age groups are susceptible to Addison’s disease, however persons between the ages of 30 and 50 are the most frequently affected.

Addison’s disease is far more prevalent in those with autoimmune polyendocrine syndrome, a rare, genetic illness in which the immune system unintentionally assaults numerous tissues and organs. Although it can affect other kinds of tissues and organs, this syndrome frequently affects your mucous membranes, adrenal glands, and parathyroid glands.

The likelihood of getting the autoimmune form of Addison’s disease is increased in those with the autoimmune diseases listed below:

• Chronic thyroiditis
• Type I diabetes
• Graves’ disease
• Pernicious anemia
• Dermatitis herpetiformis
• Vitiligo
• Myasthenia gravis